On National Women and Girls HIV/AIDS Awareness Day, March 10, groups across the country will hold events to raise awareness about the gaps in access to HIV care that many American women still face and to encourage women to get tested and seek treatment if they test positive. For more information and event listings, click here.
In the early years of the AIDS epidemic, women were often neglected in prevention and treatment efforts and campaigns, fueling the transmission of HIV among them. Today, women account for 20% of new HIV diagnoses in the U.S.—and deaths caused by AIDS—and approximately 25% of people living with HIV. The response to HIV among women has improved, and data show that in recent years new HIV infections among women in the U.S. have started to decline for the first time.
However, women are still underrepresented in many HIV-related clinical trials. They are also more likely than men to be below the poverty line—a factor that greatly compounds both risk of HIV infection and the likelihood that a person will lack access to the healthcare needed to treat HIV if they do test positive.
“In 2014, only 45% of HIV-positive women in the U.S. were engaged in HIV care, and only 32% were virally suppressed,” says Susan Blumenthal, M.D., M.P.A., amfAR senior policy and medical advisor and former U.S. Assistant Surgeon General. “In order to increase women’s access to and retention in care, we need to provide more community support services that target women’s diverse experiences in communities across the country; rectify inequalities related to income, education, and power dynamics in relationships; and address their childcare, transportation, and reproductive health needs.”
Biologically, women are more susceptible to HIV infection through heterosexual sex than men, and the vast majority of women diagnosed with HIV (84%) in the U.S. contracted the virus this way. Nationally— and globally—women of color are disproportionately impacted by HIV. According to the U.S. Centers for Disease Control and Prevention (CDC), African Americans and Latinas represent 27% of all women in the U.S., but account for nearly 80% of HIV cases among women, and African Americans constitute nearly two-thirds of new HIV diagnoses among women.
In addition, the Southern U.S. has some of the highest rates of HIV among women in the nation. Although the region has only a little over one-third of the country’s population, half of all new HIV infections occur in the South, and nearly three-quarters of women in the region newly diagnosed with HIV are Black. In Washington, D.C., Black women represent 92% of females living with HIV, and 2.6% of Black women are HIV positive —a rate higher than the HIV rate in some African countries.
The region also claims 10 of the country’s 12 poorest states, and every state in the deep South except Alabama opted out of the federally funded Medicaid expansion provided for under the Affordable Care Act—meaning that while Southern women are more likely to be infected with HIV than women in other areas, they are less likely to have access to care. As a result, the region has more AIDS diagnoses among women than all other areas in the U.S. combined.
“There are troubling racial and regional disparities regarding women and HIV,” says Blumenthal. “The HIV response can’t be one size fits all. We need to make sure that HIV messaging is targeted to diverse populations, scaled-up, and delivered to places where at-risk women will benefit from them.”